Seborrheic keratoses of penis

A case is reported of a forty-nine-year-old black man in whom numerous skin-colored papules and verrucoid plaques had developed on his penis over the course of fifteen years. He did not seek medical attention, and some of the lesions had become quite large. The initial clinical impression was condyloma acuminatum, and prior to therapeutic intervention histologic evaluation revealed findings diagnostic of seborrheic keratosis. Seborrheic keratoses should be considered in the differential diagnosis of penile lesions especially because of clinical similarities to condylomata acuminata.     

Minimal Disease in the Sentinel Lymph Node: How to Best Measure Sentinel Node Micrometastases to Predict Risk of Additional Non-Sentinel Lymph Node Disease

Background  

Volume of disease in the sentinel lymph node (SLN) is a significant predictor of additional nodal metastasis. This study assesses incidence of residual non-SLN disease in a large cohort of women with minimal SLN metastases and compares three methods of SLN micrometastasis volume measurement to determine which best predicts residual disease on completion axillary lymph node dissection (cALND).     

RF对纳米金标记的RNase-S局部加热效应的研究

目的 在纳米级或微米级结构的线度可以和热辐射波长λ相比拟的状态下的辐射热传导的研究具有重要的实用意义，通过建立生物模型来研究射频电磁辐射(RF)对纳米结构辐射热传导的特征，并探讨微波非热效应的可能作用机制。方法 将制备的纳米金标记的RNase-S样品通过常规的Poly-C水解能力的测定及哪谱的测定分析，确定酶的2级结构的重组成功和活性的存在后，比较RF对样品、水和空气的热效应。结果 通过紫外分光光度计对制备的纳米金标记的RNase-S样品的Poly-C水解能力的测定及谱的测定，表明研究中使用的生物模型和RNase A模拟得十分满意。空气浴中的封装空气样品的散热曲线呈现指数衰减规律，而空气样品的加热过程呈指数增加趋势。空气浴中的双蒸馏水样品的加热过程基本上是线性增加。但是，水浴的纳米金标记的RNase-S样品的加热过程却基本上保持恒定值。结论 RF辐射在实验的条件下会由于被加热介质的不同热物理性质表现为不同的加热效果，对于含有纳米金属的微结构，可能会在局部产生微涡流发热。以纳米颗粒为热源的辐射热传导可能会和生物大分子的结构调整发生谐振从而不表现出样品整体宏观的升温。生物功能性大分子关键部位局部加热的谐振吸收是微波等物理因素的非热生物效应的可能作用机制。     

Management of Obesity in Adults with CKD

Obesity is a leading public health problem that currently affects over 650 million individuals worldwide. Although interest in the adverse effects of obesity has grown exponentially in recent years, less attention has been given to studying its management in individuals with CKD. This relatively unexplored area should be considered a high priority because of the rapid growth and high prevalence of obesity in the CKD population, its broad impact on health and outcomes, and its modifiable nature. This article begins to lay the groundwork in this field by providing a comprehensive overview that critically evaluates the available evidence related to obesity and kidney disease, identifies important gaps in our knowledge base, and integrates recent insights in the pathophysiology of obesity to help provide a way forward in establishing guidelines as a basis for managing obesity in CKD. Finally, the article includes a kidney-centric algorithm for management of obesity that can be used in clinical practice.     

A Nomogram for Predicting the Likelihood of Additional Nodal Metastases in Breast Cancer Patients With a Positive Sentinel Node Biopsy

Background:The standard of care for breast cancer patients with sentinel lymph node (SLN) metastases includes complete axillary lymph node dissection (ALND). However, many question the need for complete ALND in every patient with detectable SLN metastases, particularly those perceived to have a low risk of non-SLN metastases. Accurate estimates of the likelihood of additional disease in the axilla could assist greatly in decision-making regarding further treatment.Methods:Pathological features of the primary tumor and SLN metastases of 702 patients who underwent complete ALND were assessed with multivariable logistic regression to predict the presence of additional disease in the non-SLNs of these patients. A nomogram was created using pathological size, tumor type and nuclear grade, lymphovascular invasion, multifocality, and estrogen-receptor status of the primary tumor; method of detection of SLN metastases; number of positive SLNs; and number of negative SLNs. The model was subsequently applied prospectively to 373 patients.Results:The nomogram for the retrospective population was accurate and discriminating, with an area under the receiver operating characteristic (ROC) curve of 0.76. When applied to the prospective group, the model accurately predicted likelihood of non-SLN disease (ROC, 0.77).Conclusions:We have developed a user-friendly nomogram that uses information commonly available to the surgeon to easily and accurately calculate the likelihood of having additional, non-SLN metastases for an individual patient.Drs. Manasseh and Bevilacqua contributed equally to the work.Dr. Bevilacqua is currently affiliated with Hospital Sírio Libanes, Instituto Brasileiro de Controle do Câncer, and Disciplina de Cirurgia Geral, Departamento de Cirurgia, Faculdade de Medicina da Univerdidade de Sao Paulo. São Paulo, Brazil; Dr. Boolbol is currently affiliated with Beth Israel Medical Center, New York, New York.